person
Mr. Derek R Wynn, PA
Medical Physician Assistant in Grangeville, Idaho
NPI 1043689441

Derek R Wynn is a Medical Physician Assistant based in Grangeville, ID and is specialized in Medical. Derek R Wynn practices in Grangeville, ID and has the professional credentials of PA. The NPI Number for Derek R Wynn is 1043689441 and holds a License No. PA-1276 (Idaho).

The current practice location address for Derek R Wynn is 607 W Main Street, Grangeville, ID and can be reached out via phone at 208-983-1700 and via fax at 208-983-4665.

Location: 607 W Main Street, Grangeville, ID, 83530-1345
person
Provider Profile Details
NPI Number
1043689441
Provider Name
Derek R Wynn
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
607 W Main Street, Grangeville, ID, 83530-1345
Phone Number
208-983-1700
Fax Number
208-983-4665
Provider Enumeration Date
09/16/2015
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
607 W Main Street
City
State
Zip
83530
Phone Number
208-983-1700
Fax Number
208-983-4665
person
Provider Business Mailing Address Details
Address
607 W Main Street
City
State
Zip
83530
Phone Number
208-983-1700
Fax Number
208-983-4665
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA-1276 (Idaho)
Definition
Definition to come...
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